Your Most Inclusive Healthcare Payment Integrity Partner

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Why Alivia–Payment Integrity

Industry-leading pre- and post-payment solutions for medical, pharmacy, vision, and dental claims, backed by our powerful, configurable Payer Analytics Platform.

Tech-Enabled Services & SaaS

We provide unmatched accuracy, efficiency, and insights, empowering organizations to enhance their financial operations and maintain compliance.

Why Alivia Analytics?

  • We identify new recoveries missed by legacy vendors 
  • We deliver actionable pre- and post-pay analytics
  • We offer automated pre-pay corrections

Solutions:

Innovative Solutions for Commercial Health Plans

  • Private Health Insurance Plans
  • Employer-Sponsored Insurance (ESI)
  • Third-Party Administrators (TPAs)
  • Self-Insured Employers
  • Commercial Health Exchanges TRUSTED PARTNER FOR 

Trusted Partner for State And Federal Agencies

  • State Medicaid Agencies
  • Centers for Medicare & Medicaid Services (CMS)
  • Veterans Health Administration (VHA)
  • Defense Health Agency (DHA)
  • Centers for Disease Control and Prevention (CDC)

Moving as Fast & Far Left as you Need

last pass to vendor insourcing v2
last pass to vendor insourcing v2

Alivia’s Claims Process Fit

pi claims process fit
pi claims process fit

Alivia Advantage

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Vendor Insourcing & Team Integration

Alivia’s AI-powered platform enables organizations to bring critical vendor functions in-house, reducing dependency on external parties and improving control over operations. With advanced tools and insights, our platform streamlines vendor management, enhances oversight, and drives strategic decision-making.

Bringing Teams Together

Our platform breaks down silos within your organization, fostering greater collaboration and transparency across different teams. By integrating diverse functions into one unified system, Alivia helps accelerate decision-making and drive innovation.

Adaptive Pre and Post Pay

Adaptive Pre- and Post-Pay Flexibility

Alivia’s platform allows for seamless transitions between pre-pay and post-pay audit scenarios, providing a dynamic approach to financial oversight. Whether addressing issues proactively or resolving discrepancies after the fact, our AI-driven solution ensures comprehensive analysis and real-time adjustments.

Move To Pre-Pay

Our platform breaks down silos within your organization, fostering greater collaboration and transparency across different teams. By integrating diverse functions into one unified system, Alivia helps accelerate decision-making and drive innovation.

Holistic Approach to Accurate Compliant Audits Icon

Holistic Approach to Accurate, Compliant Audits

Alivia’s auditing solution offers a full-spectrum review of all claims, ensuring no detail is overlooked. Our approach integrates various audit types, including data mining, clinical audits, COB, and more, providing a thorough and accurate assessment of payment integrity.

  • Duplicate Payments
  • Contractual Discrepancies
  • Upcoding and Unbundling
  • Outlier Detection
  • System Pricing Errors

AI ASSIST FUNCTIONS

Alivia’s AI capabilities extend beyond traditional data analysis, providing predictive modeling, real-time decision support, and automated workflows that enhance operational effectiveness. By leveraging AI, we help organizations avoid fraud, optimize their payment processes, and confidently make data-driven decisions.

Contact Alivia Today!

Please fill out the form below. No pressure, just a productive discussion with one of our solution experts to address your needs.